Guns, Fear, Death and Irony in Permitless-Carry America

Supreme Court Justice Alito recently said he felt “threatened by unarmed people as they used their first amendment rights to protest court decisions.

Meanwhile around the U.S. more and more states are implement the court’s permitless-carry rulings and more people around the country openly carry weapons.

Medicynical Note: Parenthetically this is a freedom created by the same conservative Supreme Court justices that now say they live in fear of being shot, in part, because of it.

Police, as a group inexplicably seem to favor all “2nd amendment rights,” including open carry. But ironically or tragically they are one of the groups at greatest risk from this “freedom.”

America leads the industrialized world in police deaths from guns, and people, innocents and perps, being shot by police. We also are the industrial world leaders in all other gun deaths including accidental shootings, mass shootings, school shootings, suicides by guns, armed assaults and robberies.

Each year local governments, pay out millions of dollars to innocents and their survivors and bystanders erroneously shot by police using excess force…..often because they work and live in fear of being shot themselves.

And all this is based on a constitutional amendment and tradition that arguably had it’s origin in slavery and racism. This is American freedom?

$35,500 Medication in U.S. …… $250 in the U.K. The U.S. Medical Scam

I’ve previously talked about the manipulation of medical prices through price gouging and medical code game playing. What follows is an example. Not unusual. It happens every day in the U.S. of A.

“Total Bill: $73,812 for the two shots ($35,414 for the first, $38,398 for the second), including lab work and physician charges. United Healthcare’s negotiated rate for the two shots plus associated fees was $27,568, of which the insurer paid $19,567. After Hinds haggled with the hospital and insurer for more than a year, his share of the bills was determined to be nearly $7,000.”

Medicynical Note: Almost everything on this bill is a manipulation of the system. First, the pricing of the lab tests. Each are inflated probably several times the actual cost of doing the test or the price of the test done for outpatients. Next, the cost of the medication leuprolide $35,000 (gasp!). This, for a drug developed in 1973 and priced at a few hundred dollar just a few years ago and costing $250 or less in overseas healthcare systems. Current pricing in various locales here. And lastly the use of codes to increase the billing i.e. separating the office visit fee from an “evaluation and management” fee. Both events, of course, happened simultaneously. Or consider the over $500 fee for a quick, less than a 1 minute, administration of a drug that has almost no immediate side effects. The nurse administering the drug didn’t even have to find a syringe to draw up the medication as it comes ready to go in a syringe.

Healthcare pricing has little to do with actual costs. This patient had insurance and paid a “negotiated” reduced but still excessive amount. But if he had no insurance he would have been billed and held accountable for the full amount, unless maybe he could claim poverty or was a skilled negotiator.

The finances of healthcare in the United States are worse than going to a used car lot and dickering for a car……and more expensive. When you understand that the CEOs’ of so-called health-care companies major concern is income not outcomes than you understand why we pay so much.

Another School Shooting….Want more of this? Vote republican

Another shooting, due, in great part, to our Republican dominated Supreme Court. Don’t like this Vote Democrat!

Medicynical Note: Another school mass shooting brought to you by the NRA, the republican party and the republican dominated Supreme Court. We have more mass shootings in one month than all of Europe has in a year. We’re number 1.

Guns, Guns, Guns

In the industrialized world only America equates freedom with gun access and ownership. It’s getting worse thanks to our conservative Supreme Court voiding any restrictions on gun ownership. New rulings complicate the problem even further.

“A judge in West Virginia this month cited the Supreme Court case when he struck down a federal law that required guns to have serial numbers. So did a judge in Texas who ruled last month that people under criminal indictments can still possess guns, and a judge who this month tossed New York’s prohibitions on carrying concealed firearms in Times Square, summer camps, subways and theaters.”

“More than a dozen other challenges to gun control laws are pending in federal courts, which legal experts say could leave holes in efforts to curb gun violence and the use of weapons in crimes.”

Medicynical note: In the U.S. with it’s guns everywhere for everyone policies, police are terrified that their response to the next traffic stop or domestic dispute or any citizen contact will result in a weaponized altercation. They treat everything as if they are at risk. Mistakes are regularly made, innocents as well as officers tragically shot and the public bears the often costly legal and moral ramifications.

The U.S. leads the industrialized world in gun murders, accidental shootings, accidental shooting by children and of children, gun suicides, police shootings, policemen getting shot, mass shootings and school shootings.

And somehow this sick partially demented (IMHO) Supreme Court Majority think this is what the founders intended (for what that’s worth 250 years later).

Another Mass Shooting….. a uniquely American event. Ever wonder why?

Thanks to our mostly “conservative” insular and isolated Supreme Court the slaughter of innocents in America continues. There have been 532 mass shootings here so far this year.

“We have doubled our determination now to end senseless gun violence that has its grips on our country and now on our city,” Raleigh Mayor Mary-Ann Baldwin said. “I know that brings us all sadness and anger. We have to do something.”

Medicynical Hint: The answer is not thoughts and prayers. The answer is not more guns. The answer is not fewer doors. The answer is not mental health counseling.

The Answer: FEWER GUNS

$80,000 and 5 ER Visits: In American healthcare it’s the INCOME not OUTCOMES

An encounter with our health care system is worse than going to a used car lot. In the latter case you more or less know before the purchase what your cost will be, albeit the route to the final price is galling.

In the U.S. healthcare non-system the sky is the limit as providers hide prices and arbitrarily raise them without consulting with the consumer. Needless to say the buyer of services is ultimately liable for the full price.

“Laub opted for the methotrexate injection. After getting the shot, patients need certain follow-up blood tests for several weeks to confirm that the pregnancy is ending or has ended. Laub returned to the emergency department for bloodwork and an ultrasound three days after the shot. She returned again three days later and was given a second shot of methotrexate since the pregnancy hadn’t terminated. The following week, she repeated the treatment in two more follow-up visits. On July 20, after 12 days and five emergency department visits, Laub was scheduled for laparoscopic surgery to remove her fallopian tube.”

“The total charges to date for the medical treatment: an eye-popping $80,000. Because her health plan had negotiated discounted rates with the hospital and the other providers, all of whom were in her provider network, Laub’s out-of-pocket cost will be a fraction of that total. It now appears Laub will owe a little more than $4,000.”

Medicynical Note: When I lived in a third world country years ago, little kids would approach me at the open market and ask for baksheesh. Every time, every single time. They’d ask whether or not I gave.

Our healthcare system is a rabbit warren of rules and regs a little like that open market. Providers always ask for the gift and diligently game the system to maximize billings. Hospitals hide prices and years ago learned that they made more by itemizing every little thing and overcharging for each item rather than by providing a comprehensive price for a service. Adding to the confusion, prices charged insurers vary widely are often tiny fractions of that charged to customers without insurance.

And yes, the multimillionaire CEO’s of healthcare companies and health insurers could care less whether you get affordable care or whether you survived your encounter with the healthcare system For them it’s the company’s income not patient outcomes that is important. That’s America.

More Guns=More Gun Deaths

This time it’s two policemen who were shot. The U.S. leads industrialized nations in this statistic as well. The US leads the industrialized world in literally every reportable gun death statistic. A dubious distinction.

Medicynical Note: Once an idyllic place with the highest standard of living and overall great satisfaction with the quality of life (unless of course you were African-American or indigent). The U.S. with it’s “conservative” values has become a country of increasing income disparity, guns everywhere, mediocre health care (we lead the world in COVID deaths), systemic racism, white angst, and gun deaths. Not a pretty picture.

We owe this to Vladimir Putin, one of the worst Supreme Courts in history, a congress increasingly manned by incompetents and a clueless citizenry. We’re in a national libertarian/conservative/faux religionist downward spiral to who knows what.

Guns….My Morning Reads

Medicynical Note: The other fatal epidemic in America. Guns terrify everyone and in the U.S. they are everywhere. A uniquely American problem (we lead the world in ownership and deaths) in a once civil society that absurdly maintains that it values life.

It should also be noted that in the other epidemic the U.S. also leads the world in deaths. What the hell is wrong with us?

Republican Salami Tactics Undermine Our Democracy

In Eastern Europe after WWII the Soviets consolidated power by undermining countries monarchies and fledgling democracies by subverting elections, the judiciary, police authorities and political parties. This strategy was termed salami tactics—undermining by a thousand cuts.

We are now facing a similar Republican/Trumpian strategy. They are literally taking apart our elections, Judiciary and soon our political structure with a thousand cuts. And sadly the Supreme Court seems a key part of this undoing.

This article from Slate explained salami tactics in 2019……its even worse now. Call it what you like our Democracy is threatened and maybe by this point finished as we know it.

Medicynical Note: Our republican friends are attempting to subvert the election process in states in which they control the legislatures; they are gerrymandering beyond all previous such actions; inhibiting the vote in areas where the opposition resides; not recognizing the validity of fully validated elections (they lost by millions) and are openly supporting violent insurrection. It’s happening now in the U.S.

Putin: Very Trumpian

Remarkable performance by Vladdy. Following Trump’s lead in inventing narratives that are counterfactual. Up is down—only because I say so.

While threatening war and massing troop at the border, claims the other side is threatening.—with no troops, no military presence……..just COVID.

Medicynical Noter: Chutzpah.